Dataset Information

Quality of intrapartum and newborn care in Tigray, Northern Ethiopia.

ABSTRACT:

Background

Quality intrapartum and newborn care is considered to be poor in Sub-Saharan Africa. However, studies done in Ethiopia are limited. Therefore, this study was conducted to assess the magnitude and factors associated with quality intrapartum and newborn care in Tigray, Northern Ethiopia.

Methods

Facility based survey was conducted from December 2014 to February 2015 in Tigray, Northern Ethiopia. The quality of intrapartum care provided by a total of 106 skilled birth attendants to 216 labouring mothers and newborns were observed during childbirth in the health facilities. Standardized questionnaires and checklist were utilized to collect data. Quality of intrapartum service was measured using standard intrapartum criteria. Thus, good quality service was considered if the mother and newborn scored 75% or more of the intrapartum criteria during childbirth. Binary and multiple logistic regression model was used to determine the factors associated with quality intrapartum and newborn care services.

Results

29.2% of mothers and 67.6% newborns received good quality care during intrapartum and immediate postpartum periods respectively. However, only 47.2% of mothers and newborns received a friendly care during childbirths. The independent predictors of quality intrapartum and newborn care were the appropriate use of partograph (AOR 3.92; 95% CI 1.78, 8.63), friendly maternal and newborn care services (AOR 7.9; 95% CI 3.59, 17.33), more than two years working experience (AOR 0.31; 95% CI 0.13, 0.73) and using services in different Zones in the study area.

Conclusions

The quality intrapartum care is poor in the study area and it is associated with inappropriate use of partograph, unfriendly care, and experience of health providers. Scaling up obstetric service, continuous training and motivation of service providers and revising the criterion for accreditation of service providers are important.

SUBMITTER: Fisseha G

PROVIDER: S-EPMC6339373 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Quality of intrapartum and newborn care in Tigray, Northern Ethiopia.

Fisseha Girmatsion G Berhane Yemane Y Worku Alemayehu A

BMC pregnancy and childbirth 20190118 1

<h4>Background</h4>Quality intrapartum and newborn care is considered to be poor in Sub-Saharan Africa. However, studies done in Ethiopia are limited. Therefore, this study was conducted to assess the magnitude and factors associated with quality intrapartum and newborn care in Tigray, Northern Ethiopia.<h4>Methods</h4>Facility based survey was conducted from December 2014 to February 2015 in Tigray, Northern Ethiopia. The quality of intrapartum care provided by a total of 106 skilled birth atte ...[more]

PMID: 30658706

Similar Datasets

Project description:BackgroundDespite much progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal and newborn deaths and stillbirths. Ethiopia's plan to meet the sustainable development goals for maternal and child health includes unprecedented emphasis on improving quality of care. The purpose of this study was to assess the quality of midwifery care during labor, delivery and immediate postpartum period.MethodsA cross-sectional study using multiple data collection methods and a 2-stage cluster sampling technique was conducted from January 25 to February 14, 2015 in government health facilities of the Amhara National Regional State of Ethiopia. Direct observation of performance was used to determine competence of midwives in providing care during labor, delivery, and the first 6 h after childbirth. Inventory of drugs, medical equipment, supplies, and infrastructure was conducted to identify availability of resources in health facilities. Structured interview was done to assess availability of resources and performance improvement opportunities. Data analysis involved calculating percentages, means and chi-square tests.ResultsA total of 150 midwives and 56 health facilities were included in the study. The performance assessment showed 16.5% of midwives were incompetent, 72.4% were competent, and 11.1% were outstanding in providing routine intrapartum care. Forty five midwives were observed while managing 54 obstetric and newborn complications and 41 (91%) of them were rated competent. Inventory of resources found that the proportion of facilities with more than 75% of the items in each category was 32.6% for drugs, 73.1% for equipment, 65.4% for supplies, 47.9% for infection prevention materials, and 43.6% for records and forms. Opportunities for performance improvement were inadequate, with 31.3% reporting emergency obstetric and newborn care training, and 44.7% quarterly or more frequent supportive supervision. Health centers fared worse in provider competence, physical resources, and quality improvement practices except for supportive supervision visits and in-service training.ConclusionsAlthough our findings indicate most midwives are competent in giving routine and emergency intrapartum care, the major gaps in the enabling environment and the significant proportion of midwives with unsatisfactory performance suggest that the conditions for providing quality intrapartum care are not optimal.

Project description:BackgroundEfforts to expand access to institutional delivery alone without quality of care do not guarantee better survival. However, little evidence documents the quality of childbirth care in Ethiopia, which limits our ability to improve quality. Therefore, this study assessed the quality of and barriers to routine childbirth care signal functions during intra-partum and immediate postpartum period.MethodsA sequential explanatory mixed method study was conducted among 225 skilled birth attendants who attended 876 recently delivered women in primary level facilities. A multi stage sampling procedure was used for the quantitative phase whilst purposive sampling was used for the qualitative phase. The quantitative survey recruitment occurred in July to August 2018 and in April 2019 for the qualitative key informant interview and Focus Group Discussions (FGD). A validated quantitative tool from a previous validated measurement study was used to collect quantitative data, whereas an interview guide, informed by the literature and quantitative findings, was used to collect the qualitative data. Principal component analysis and a series of univariate and multivariate linear regression analysis were used to analyze the quantitative data. For the qualitative data, verbatim review of the data was iteratively followed by content analysis and triangulation with the quantitative results.ResultsThis study showed that one out of five (20.7%, n = 181) mothers received high quality of care in primary level facilities. Primary hospitals (? = 1.27, 95% CI:0.80,1.84, p = 0.001), facilities which had staff rotation policies (? = 2.19, 95% CI:0.01,4.31, p = 0.019), maternal involvement in care decisions (? = 0.92, 95% CI:0.38,1.47, p = 0.001), facilities with maternal and newborn health quality improvement initiatives (? = 1.58, 95% CI:0.26, 3.43, p = 0.001), compassionate respectful maternity care training (? = 0.08, 95% CI: 0.07,0.88, p = 0.021), client flow for delivery (? = 0.19, 95% CI:-0.34, -0.04, p = 0.012), mentorship (? = 0.02, 95% CI:0.01, 0.78, p = 0.049), and providers' satisfaction (? = 0.16, 95% CI:0.03, 0.29, p = 0.013) were predictors of quality of care. This is complemented by qualitative research findings that poor quality of care during delivery and immediate postpartum related to: work related burnout, gap between providers' skill and knowledge, lack of enabling working environment, poor motivation scheme and issues related to retention, poor providers caring behavior, unable translate training into practice, mismatch between number of provider and facility client flow for delivery, and in availability of essential medicine and supplies.ConclusionsThere is poor quality of childbirth care in primary level facilities of Tigray. Primary hospitals, facilities with staff rotation, maternal and newborn health quality improvement initiatives, maternal involvement in care decisions, training on compassionate respectful maternity care, mentorship, and high provider satisfaction were found to have significantly increased quality of care. However, client flow for delivery service is negatively associated with quality of care. Efforts must be made to improve the quality of care through catchment-based mentorship to increase providers' level of adherence to good practices and standards. More attention and thoughtful strategies are required to minimize providers' work-related burnout.

Project description:INTRODUCTION:Neural tube defects are the major causes of fetal loss and considerable disabilities in infants. Currently, there is no significant research on the incidence of Neural tube defects in the Tigray region of Ethiopia. OBJECTIVE:To determine the incidence and clinical pattern of the Neural Tube Defects. METHODS:A hospital-based cross-sectional study was conducted from October 2016 to June 2017. All pregnancy outcomes were examined for any externally visible birth defects and neurological integrity by trained midwives under the supervision of senior obstetrics and gynecology and a neurosurgeon. Data were collected using a survey tool to collect maternal and newborn demographic data and a checklist developed to capture newborns with Neural Tube Defects. Data were analyzed using SPSS version 20. The prevalence of NTDs was calculated per 10,000 births. RESULT:Out of the 14,903 births during the study period, a total of 195 infants were born afflicted with Neural Tube Defects. The burden of infants with anencephaly and spina bifida was 66.4 and 64.4 per 10, 000 births, respectively. The overall incidence rate of NTDs in this study was 131 per 10, 000 births of which 23% were liveborn and 77% were stillborn. The highest burden of Neural Tube Defects was observed in Adigrat Hospital from Eastern Zone of Tigray (174 per 10,000 births) and Lemlem Karl Hospital from Southern Zone of Tigray (304 per 10,000 births) compared to Kahsay Abera Hospital from Western Zone (72.8 per 10,000 births) and Sihul Hospital from North Western Zone of Tigray (69.8 per 10,000 births). CONCLUSION AND RECOMMENDATION:Assuming that the non folic acid preventable rate should be 5 per 10,000 births, our prevalence rate is 131 per 10,000 births, and then we have a rate or an epidemic that is 26 times what it should be. This just emphasizes the urgency to implement effective programs to get all women of reproductive age to have adequate folic acid to prevent all of folic acid-preventable spina bifida and anencephaly, which would prevent 96% (125/130) of spina bifida and anencephaly in the Tigray Provence.

Project description:BACKGROUND:Despite progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal deaths. As facility-based childbirth and skilled-birth attendant at birth reduces maternal morbidity and mortality, the country has been implementing expansions in infrastructure during the past decades. Whether this phenomenal expansion in infrastructure and improvement in coverage of healthcare services matched with quality of maternal health service is not well investigated. This study assessed the quality of intrapartum care experienced by mothers at health centers in Jabi Tehinan district, North West Ethiopia. METHOD:An institution-linked community-based cross-sectional study was carried out from August to September 2018 to assess the quality of intrapartum care experienced by mothers during facility deliveries. Quantitative data were collected from 378 women who had uncomplicated births at health centers within 6?months preceding the survey and interviews were held with 25 women. The quantitative data were entered into SPSS for Windows versions 23 for analyses. Qualitative data were transcribed verbatim and data were used to substantiate the quantitative data. RESULT:The results indicated that 13% of mothers experienced good quality of intrapartum care services. About 49, 45, 31, and 25% of mothers respectively experienced good quality of human and physical resources; respect, dignity, and equity; emotional support; and cognition. Only 2% of mothers experienced good quality of services on the four dimensions and 15% did not experience good quality of services on neither of the dimensions. Mothers from rural areas and mothers who did not use ANC services for recent born children were found more likely to experience good quality of intrapartum care. Informants discussed poor quality of labor environment, lack of privacy, and poor client-provider communications at health facilities. CONCLUSION:The results indicated that the quality of intrapartum care experienced by mothers were minimal. The findings highlighted that efforts exerted to increase infrastructure and improve maternal health service coverage did not ensure quality maternal health services. Therefore, to increase the uptake of facility births and improved maternal health outcomes, stakeholders should make the health system humane, respectful, equitable, and responsive to mothers' concerns.

Dataset Information

Quality of intrapartum and newborn care in Tigray, Northern Ethiopia.

Background

Methods

Results

Conclusions

Publications

Quality of intrapartum and newborn care in Tigray, Northern Ethiopia.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets